Letter: Hospital league tables: statistics that confuse efficiency with effectiveness

Sir: You acknowledge your analysis of 'best' and 'worst' hospitals as crude, and then present us with a map founded on that analysis. But unsound statistical practices are unsound, not crude, and they result in mistakes, not 'broad pictures'. For example, in your map based on the 'Star system', you give Salisbury Health Care the black box treatment - lowest rated hospital. In fact, it is one of the best.

Four out of every five hospitals come out worse on day-case surgery indicators; and your example of 'the best' - St George's, Tooting - has more patients waiting longer than 30 minutes for an outpatient appointment, not fewer. Salisbury beats St George's five to one on the first six indicators in your tables. We only lose out on the waiting times, but has anyone thought that that might actually point to good clinical performance?

GPs are referring to Salisbury because they want the service our doctors provide. Quite simply, demand is outstripping supply, despite our surgeons' masterly efforts to speed things up - great day-surgery rates, for example - and the very impressive ratios of operations per surgeon that they achieve. Improved productivity taken on its own won't fix it: we need extended contracts to support the extra work we could do, and that means help from the health authorities that purchase our services.

Yours faithfully,

CHRISTOPHER MOULD

Chief Executive

ERIC WATERS

Medical Director

Salisbury Health Care

Salisbury, Wiltshire

30 June